Claim total
$982.78
base $93.83 · payer covered $882.78
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2017-03-11
- Stop
- 2017-03-11
The parties
- Patient
- patient Zachery Vincenzo Berge
- Provider
- provider Ursula Nolan
- Payer
- payer Medicaid
Record id
01ce818c-8f9f-924a-622e-d5e46e593988